Tesis

Analisis Gangguan Fungsi Paru pada Pekerja dengan Pajanan Pelarut Organik di Pabrik Sepatu PT.X = Analysis of Lung Function Impairment due to Solvent Exposure in Shoes Maker Workers .

Latar Belakang : Pekerja di manufaktur sepatu setiap hari terpajan beragam hazard. Salah satu pajanan adalah pelarut organik. Berbagai penelitian melaporkan hubungan yang kuat antara pajanan pelarut organik dengan gangguan fungsi paru obstruktif dan restriktif. Namun, belum banyak studi dilakukan untuk mempelajari hubungan antara pajanan pelarut organik di manufaktur sepatu dengan faktor-faktor risiko dan gejala klinis gangguan fungsi paru. Metode : Desain potong lintang, melibatkan 134 subyek, cementing (n=67) dan stockfit (n=67). Bagian cementing, terpajan pelarut Aseton, bagian stockfit, oleh campuran pelarut Aseton dan Klorin. Seluruh subyek dilakukan pemeriksaan fungsi paru menggunakan spirometer menilai KVP dan VEP1/KVP. Subyek dilakukan interview untuk mengetahui gejala klinis, riwayat penyakit dahulu dan riwayat pekarjaan. Kadar pelarut organik di kedua tempat diukur. Analisis statistik menggunakan Chi square dengan p 0,05) Disebabkan masa kerja < 10 tahun. Proporsi subyek dengan gejala bronkitis kronik, di cementing 40,3%, stockfit 62,7%. Analisis chi-square menegaskan adanya hubungan bermakna. Di bagian cementing, diperoleh hasil berikut, faktor risiko umur (p < 0,05), masa kerja (p < 0,05), dan total kumulatif pajanan (p < 0,015). Di bagian stockfit, faktor risiko masa kerja memiliki p < 0,05 dan total kumulatif pajanan p < 0,05. Dan hasil uji regresi logistik didapat bahwa di bagian cementing, masa kerja faktor risiko dominan terhadap gejala bronkitis kronik p =0,008, ORadj 12,100 dengan CI95% (1,92 – 76,23). Stockfit faktor risiko dominan total kumulatif pajanan p=0,039, ORadj 6,667, CI95% (1,01 – 40,43). Kesimpulan : Dari studi dapat disimpulkan bahwa pajanan pelarut organik mengakibatkan gejala klinis bronkitis kronik yang berhubungan dengan faktor risiko usia, masa kerja, dan total kumulatif pajanan. Tidak ada hubungan bermakna antara pajanan pelarut organik terhadap gangguan fungsi paru. Perlu langkah preventif guna mencegah berkembangnya gejala bronkitis kronik menjadi gangguan fungsi paru. Dilakukan dengan pemakaian alat pelindung diri yang sesuai dengan pajanan kimia dan pemasangan local exhaust.
Kata kunci : gangguan fungsi paru, pelarut organik, manufaktur sepatu,bronkitis kronik


Background : Depending on the kinds of production sites, shoe factory workers are exposed to many kinds of occupational hazards with one of them being exposure to organic solvent. Organic solvent exposure has been reported to have adverse pulmonary effects including obstructive and restrictive pulmonary diseases. The study aimed to investigate association between organic solvent exposure, risk factors, and clinical symptoms of pulmonary function impairment among shoe factory workers. Methods : Cross sectional study group consist of 134 workers in two different production parts i.e. cementing and (n=67)and stockfit (n=67). Subjects work in cementing part were exposed to acetone, while in stockfit to a combination of acetone and chlorine. To all subjects, pulmonary functions testing including measurements of FVC and FEV /FVC values were performed using spirometer. Interviews were also performed asking about clinical symptoms and the histories of both their health and work records. Statistic analysis using Chi-square p 0.05), This is probably due to the short work duration of the subjects (< 10 years). Despite this observation, it is important to note that the study strongly identified chronic bronchitis symptoms among workers in both cementing (40.3%)and in stockfit (62.7%). Furthermore, chi- square analysis showed significant correlation between risk factors and chronic bronchitis symptoms in both places. In cementing, it was observed that age (p < 0.05), work duration (p < 0.05)and total cumulative exposure (p < 0.015)were significantly contributed to the symptoms. Whereas in stockfit, the risk factors were as follows, work duration (p < 0.05)and total cumulative exposure (p < 0.05). Logistic regression analysis showed that in cementing, work duration was observed to be the greatest risk factor to the bronchitis related-symptoms , p < 0,008, OR 12,100 and CI95% (1,92 – 76,23). whereas in stockfit, total cumulative exposure was associated the most with the symptoms p0,039 OR 6,667 CI95% (1,099 – 40,434)Conclusions :The results from the present study indicate that occupational exposure to organic solvent has significant association with clinical symptoms related to chronic bronchitis. Risk factors such as age, work duration, and total cumulative exposure are observed to contribute to the symptoms. However, exposure to organic solvent did not significantly caused lung function disorders. Preventions are required to avoid the clinical symptoms develop into pulmonary impairment, such as the use personal protection equipment and local exhaust apparatus.
Keywords: pulmonary function impairment, organic solvent, shoe manufacture, chronic bronchitis